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  • Hellmich, BernhardUniversity of Tübingen (author)

2018 Update of the EULAR recommendations for the management of large vessel vasculitis

  • Article/chapterEnglish2020

Publisher, publication year, extent ...

  • 2019-07-03
  • BMJ,2020

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:f87a26fd-18a9-43d2-b3c8-d911796af654
  • https://lup.lub.lu.se/record/f87a26fd-18a9-43d2-b3c8-d911796af654URI
  • https://doi.org/10.1136/annrheumdis-2019-215672DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Background: Since the publication of the European League Against Rheumatism (EULAR) recommendations for the management of large vessel vasculitis (LVV) in 2009, several relevant randomised clinical trials and cohort analyses have been published, which have the potential to change clinical care and therefore supporting the need to update the original recommendations. Methods: Using EULAR standardised operating procedures for EULAR-endorsed recommendations, the EULAR task force undertook a systematic literature review and sought opinion from 20 experts from 13 countries. We modified existing recommendations and created new recommendations. Results: Three overarching principles and 10 recommendations were formulated. We recommend that a suspected diagnosis of LVV should be confirmed by imaging or histology. High dose glucocorticoid therapy (40-60 mg/day prednisone-equivalent) should be initiated immediately for induction of remission in active giant cell arteritis (GCA) or Takayasu arteritis (TAK). We recommend adjunctive therapy in selected patients with GCA (refractory or relapsing disease, presence of an increased risk for glucocorticoid-related adverse events or complications) using tocilizumab. Methotrexate may be used as an alternative. Non-biological glucocorticoid-sparing agents should be given in combination with glucocorticoids in all patients with TAK and biological agents may be used in refractory or relapsing patients. We no longer recommend the routine use of antiplatelet or anticoagulant therapy for treatment of LVV unless it is indicated for other reasons. Conclusions: We have updated the recommendations for the management of LVV to facilitate the translation of current scientific evidence and expert opinion into better management and improved outcome of patients in clinical practice.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Agueda, AnaCentro Hospitalar do Baixo Vouga (author)
  • Monti, SaraUniversity of Pavia (author)
  • Buttgereit, FrankCharité - University Medicine Berlin (author)
  • De Boysson, HubertCentre Hospitalier Universitaire Côte de Nacre (author)
  • Brouwer, ElisabethUniversity Medical Center Groningen (author)
  • Cassie, RebeccaNo affiliation available (private) (author)
  • Cid, Maria CintaUniversity of Barcelona (author)
  • Dasgupta, BhaskarSouthend Hospital (author)
  • Dejaco, ChristianMedical University of Graz (author)
  • Hatemi, GulenIstanbul University (author)
  • Hollinger, NicoleUniversity of Tübingen (author)
  • Mahr, AlfredParis Diderot University (author)
  • Mollan, Susan P.University Hospitals Birmingham,University of Birmingham (author)
  • Mukhtyar, ChetanNorfolk and Norwich University Hospital NHS Trust (author)
  • Ponte, CristinaUniversity of Lisbon,Instituto de Medicina Molecular, Lisboa (author)
  • Salvarani, CarloArcispedale Santa Maria Nuova (author)
  • Sivakumar, RajappaGLB Hospitals and Acute Stroke Centers (author)
  • Tian, XinpingPeking Union Medical College (author)
  • Tomasson, GunnarUniversity of Iceland (author)
  • Turesson, CarlLund University,Lunds universitet,Skåne University Hospital(Swepub:lu)med-ctn (author)
  • Schmidt, WofgangImmanuel Hospital Berlin (author)
  • Villiger, Peter M.Bern University Hospital (author)
  • Watts, RichardUniversity of East Anglia (author)
  • Young, ChrisNo affiliation available (private) (author)
  • Luqmani, Raashid AhmedUniversity of Oxford (author)
  • University of TübingenCentro Hospitalar do Baixo Vouga (creator_code:org_t)

Related titles

  • In:Annals of the Rheumatic Diseases: BMJ79:1, s. 19-300003-49671468-2060

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